WmHipaa - HIPAA EDI Processing Module
Overview
WmHipaa provides HIPAA EDI (Electronic Data Interchange) transaction processing capabilities for webMethods Integration Server, including parsing, validation, and Trading Networks integration.
Supported HIPAA Transactions
- 270 - Health Care Eligibility/Benefit Inquiry
- 271 - Health Care Eligibility/Benefit Response
- 276 - Health Care Claim Status Request
- 277 - Health Care Claim Status Response
- 278 - Health Care Services Review Information
- 820 - Payroll Deducted and Other Group Premium Payment
- 834 - Benefit Enrollment and Maintenance
- 835 - Health Care Claim Payment/Advice
- 837 - Health Care Claim (Professional, Institutional, Dental)
- 999 - Implementation Acknowledgment
- TA1 - Interchange Acknowledgment
Version Support
Key Features
- X12 EDI Parsing: Inbound and outbound message processing with automatic delimiter detection
- Multi-Level Validation: Syntax, implementation guide, and code source validation
- Code Source Management: Support for ICD-10, CPT, HCPCS, and other medical code sets
- Trading Networks Integration: Automatic document type registration and TPA management
- Acknowledgment Generation: Automatic TA1 and 999 acknowledgment creation
- Error Reporting: Detailed HTML/XML validation reports with error categorization
- Envelope Processing: ISA/GS/ST envelope handling with control number management
- 9.6 - On-Premise Pre 12.x IS version
- 9.6.0 - Cloud DADA Pre 12.x IS version